摘要
目的探讨经皮穴位电刺激辅助麻醉对胸科手术患者血浆β-内啡肽(β-EP)、5-羟色胺(5-HT)和前列腺素E2(PGE2)水平及疼痛的影响。方法将2020年1月—2020年12月于辽宁中医药大学附属医院行胸腔镜下肺叶切除的72例患者按随机数字表法分为对照组及试验组,各36例。两组术中均接受常规麻醉,试验组在此基础上行经皮穴位电刺激,术后观察48 h。比较两组麻醉药物用量,术后48 h镇痛泵按压次数,术后2、24、48 h疼痛,术前、术后即刻血浆细胞因子及术后48 h不良反应发生情况。结果术后2、24、48 h两组视觉模拟评分(VAS)呈降低趋势,且试验组低于对照组(P<0.05),术后48 h试验组镇痛泵按压次数少于对照组(P<0.05)。试验组舒芬太尼、瑞芬太尼、丙泊酚用量均低于对照组(P<0.05)。与术前比较,术后即刻两组血浆β-EP、5-HT和PGE2水平均升高(P<0.05),试验组血浆β-EP水平高于对照组,血浆5-HT和PGE2水平低于对照组(P<0.05)。术后48 h,试验组恶心、躁动发生率低于对照组(5.56%vs 22.22%,2.78%vs 25.00%,P<0.05)。结论经皮穴位电刺激辅助麻醉可调节胸科手术患者血浆β-EP、5-HT、PGE2分泌,调节机体制痛机制,缓解患者疼痛,降低麻醉药物用量及镇痛泵按压次数,且安全性较高。
Objective To investigate the effects of transcutaneous acupoint electrical stimulation assisted anesthesia on plasma levels ofβ-endorphin(β-EP),5-hydroxytryptamine(5-HT)and prostaglandin E2(PGE2)and pain in patients undergoing thoracic surgery.Methods From January 2020 to December 2020,72 patients who underwent video-assisted thoracoscopic surgery(VATS)in the affiliated hospital of Liaoning university of traditional Chinese medicine were randomly divided into the control group and the test group by random number table method,with 36 cases in each group.Both groups received routine anesthesia,and the test group received transcutaneous acupoint electrical stimulation on the basis of routine anesthesia,both groups were observed 48 h after surgery.The dosage of anesthetics,times of analgesia pump 48 h after surgery,pain at 2 h,24 h and 48 h after surgery,plasma cytokines before and immediately after surgery,and incidence of adverse reactions after surgery were compared between the two groups.Results At 2 h,24 h and 48 h after surgery,the visual analog scale(VAS)score of the two groups showed a decreasing trend,and the test group was lower than that of the control group(P<0.05),and 48 h after surgery the number of pressing analgesia pump of the test group was lower than that of the control group after surgery(P<0.05).The dosage of sufentanil,remifentanil,propofol in the test group were lower than those in the control group(P<0.05).Compared with before surgery,plasma levels ofβ-EP,5-HT and PGE2 increased in both groups immediately after surgery(P<0.05),the level of plasmaβ-EP in the test group was higher than that in the control group immediately after surgery,and the levels of plasma 5-HT and PGE2 in the test group were lower than those in the control group immediately after surgery(P<0.05).48 h after surgery,the incidence of nausea and agitation in the test group were lower than that in the control group(5.56%vs 22.22%,2.78%vs 25.00%,P<0.05).Conclusion Transcutaneous acupoint electrical stimulation assisted anesthesia could adjust the secretion of plasmaβ-EP,5-HT and PGE2 in patients with thoracic surgery,regulate the mechanism of body pain,relieve the pain of patients,reduce the dosage of anesthetics and the times of pressing analgesia pump,with higher safety.
作者
时艳杰
王铁东
曹鑫蔚
韩路
SHI Yanjie;WANG Tiedong;CAO Xinwei;HAN Lu(Affiliated Hospital of Liaoning University of Traditional Chinese Medicine,Shenyang 110032,Liaoning,China)
出处
《辽宁中医药大学学报》
CAS
2021年第9期190-193,共4页
Journal of Liaoning University of Traditional Chinese Medicine
基金
辽宁省教育厅项目(L202002)
关键词
经皮穴位电刺激
胸科手术
麻醉
β-内啡肽
前列腺素E2
5-羟色胺
疼痛
transcutaneous acupoint electrical stimulation
thoracic surgery
anesthesia
β-endorphin
prostaglandin E2
5-hydroxytryptamine
pain
作者简介
时艳杰(1988-),女,辽宁朝阳人,主治医师,博士研究生,研究方向:老年临床麻醉与围术期的疼痛管理;通讯作者:王铁东(1970-),男,辽宁沈阳人,主任医师,博士,研究方向:中西医结合临床麻醉与镇痛。E-mail:755030937@qq.com。
